| NPI | 1255880738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.136810) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35.136810) |
| 204F00000X Transplant Surgery (Licence: PA MD458391) | |
| 282N00000X General Acute Care Hospital (Licence: OH 35.136810) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2021-01-07 |